Hemodialysis vascular access complications: Recognition and management

Of the 3 basic types of vascular access for hemodialysis (arteriovenous [AV] fistula, AV graft, venous catheter), AV fistula is the method of choice, and is associated with lower complication rates. Physical examination can accurately detect and localize stenosis and thrombosis in AV fistulas/grafts. There is no consensus supporting the routine use of either anticoagulants or antiplatelet strategies to reduce the risk of thrombosis in long-term use of vascular access. Special attention must be paid to diabetic patients with neuropathy, as they have an increased risk of developing ischemic complications from their AV access.